Individual
DEIDRE RENE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5300 ZEBULON RD, MACON, GA 31210-2199
(478) 405-4500
Mailing address
301 S CORDER RD APT 801, WARNER ROBINS, GA 31088-5718
(229) 848-9001
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000781
GA
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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